As-needed inhaled corticosteroids vs routine inhaled corticosteroids for asthmachildren: An evidence-based analysis of safety and efficacy / 第二军医大学学报

ABSTRACT

Objective To compare the safety and efficacy of intermittent inhaled corticosteroids (ICS, test group) and routine ICS (control group) treatment strategy for asthma in children. Methods Databases of PubMed, Cochrane Library, clinicaltrials. gov and Chinese Biomedical Literature were searched for relevant studies published from 1980 to 2013. Results Using the predefined key words, we identified 943 citations, and finally 4 parallel-designed, prospective, randomized controlled studies (5 comparison groups) were included in this meta-analysis. We found thatthere were no significant differences between the two groups in terms of incidence of asthma exacerbations (OR 1. 25, 95 %CI 0. 87-1. 78, P = 0. 22), re-hospitalization rate(0R 0.85, 95%CI0. 28-2. 57, P = 0. 77), improvement of symptoms and life quality (WMD 0.02, 95% CI -0.19-0.23, P = 0. 88), or incidence of overall severe adverse events (0R; 0.81, 95 %CI0. 30-2. 17, P = 0. 67). However, improvement of the peak expiratory flow rate (PEFR) in the control group was significantly greater than that in the test group (WMD 2.76, 95%CI0. 69-4. 82, P = 0. 009), and the increase of body height in the test group was significantly greater than (by0. 51 cm) that inthe control group (WMD -0. 51, 95%CI -0. 87--0. 16, P = 0. 005). Heterogeneity analysis showed that the studies had good homogeneity. Conclusion The as-needed ICS and routine ICS have similar efficacy in treatment of child asthma. Routine ICS can greatly improve the PEFR, but it may have an adverse impact on the body height of Children.